Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $181.97 / $758.58	Facility	26	$125.89	$181.97	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $524.81 / $1,905.46	Professional		$331.13	$524.81	$1,905.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $169.82 / $446.68	Professional	26	$102.33	$169.82	$446.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $1,148.15	Professional	TC	$218.78	$338.84	$1,148.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $309.03	Professional		$141.25	$263.03	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $102.33 / $199.53	Professional	26	$83.18	$102.33	$199.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $204.17 / $346.74	Professional	TC	$190.55	$204.17	$346.74
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $1,096.48	Professional		$112.20	$177.83	$1,096.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $630.96 / $1,380.38	Professional		$281.84	$630.96	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $141.25 / $229.09	Professional	26	$79.43	$141.25	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $436.52 / $1,122.02	Professional	TC	$194.98	$436.52	$1,122.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $457.09 / $2,511.89	Professional		$380.19	$457.09	$2,511.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $144.54 / $2,511.89	Professional	26	$123.03	$144.54	$2,511.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $309.03 / $2,511.89	Professional	TC	$257.04	$309.03	$2,511.89
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $758.58	Professional		$316.23	$371.54	$758.58
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $109.65 / $186.21	Professional	26	$93.33	$109.65	$186.21
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $524.81	Professional	TC	$223.87	$263.03	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $501.19 / $1,071.52	Professional		$281.84	$501.19	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $117.49 / $229.09	Professional	26	$85.11	$117.49	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $331.13 / $870.96	Professional	TC	$190.55	$331.13	$870.96